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Master Thesis

Effets centraux de la toxine botulique : approche neurophysiologique chez le patient hémiplégique spastique après un AVC

Abstract : Introduction : The therapeutic effects of intramuscular injections of Botulinum toxin type A (BTx) on spasticity can be largely explained by its blocking action at the neuromuscular junction. BTx is assumed to also have a central action by affecting the functional organization of the CNS. The aim of the present study is to assess the action of BTx on spinal motor networks by investigating the post-activation depression (Post-AD) of the soleus H-reflex in post-stroke patients presenting lower limb spasticity. Methods : Soleus H-reflex was investigated in chronic hemiplegic patients before and 3, 6, 12 weeks after BTxinjections in soleus. H-reflex amplitude was analyzed in response to electrical stimulation of the tibial nerve at 0.1 Hz and 0.5 Hz. Post-AD was quantified as the ratio H0.5 Hz/H0.1 Hz. Results : The Post-AD was significantly reduced in the affected side compared to the non-affected side before BTx injection. Three weeks after injection, the Post-AD was reinforced in the paretic leg and significantly higher than in pre-injection condition. Conclusion : BTx-treatment restores the Post-AD of soleus H-reflex in post-stoke paretic patients. As Post-AD amount is correlated to the severity of spasticity, it can be assumed that BTx’s
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https://dumas.ccsd.cnrs.fr/dumas-01774575
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Marjorie Kerzoncuf. Effets centraux de la toxine botulique : approche neurophysiologique chez le patient hémiplégique spastique après un AVC. Sciences du Vivant [q-bio]. 2014. ⟨dumas-01774575⟩

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